How much rates vary
Facilitymedian $646 · 10th to 90th $427 to $1,072Professionalmedian $562 · 10th to 90th $288 to $851
Distribution of negotiated rates across all payers (price axis is log-scale). Need provider-level prices or 24+ months of history? Contact us.
Rates by insurance carrier
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Professional Modifier None Typical Low $426.58 Median $562.34 Typical High $562.34 | Professional | None | $426.58 | $562.34 | $562.34 |
BCBS Idaho Setting Facility Modifier None Typical Low $512.86 Median $645.65 Typical High $1,071.52 | Facility | None | $512.86 | $645.65 | $1,071.52 |
BCBS Idaho Setting Professional Modifier None Typical Low $467.74 Median $707.95 Typical High $741.31 | Professional | None | $467.74 | $707.95 | $741.31 |
Cigna Setting Facility Modifier None Typical Low $501.19 Median $501.19 Typical High $524.81 | Facility | None | $501.19 | $501.19 | $524.81 |
Cigna Setting Professional Modifier None Typical Low $371.54 Median $371.54 Typical High $501.19 | Professional | None | $371.54 | $371.54 | $501.19 |
Moda Health Setting Facility Modifier None Typical Low $186.21 Median $562.34 Typical High $676.08 | Facility | None | $186.21 | $562.34 | $676.08 |
Moda Health Setting Professional Modifier None Typical Low $426.58 Median $645.65 Typical High $707.95 | Professional | None | $426.58 | $645.65 | $707.95 |
Molina Setting Professional Modifier None Typical Low $30.20 Median $489.78 Typical High $575.44 | Professional | None | $30.20 | $489.78 | $575.44 |
MountainHealth Co-op Setting Facility Modifier None Typical Low $537.03 Median $851.14 Typical High $40,738.03 | Facility | None | $537.03 | $851.14 | $40,738.03 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $676.08 Median $851.14 Typical High $47,863.01 | Professional | None | $676.08 | $851.14 | $47,863.01 |
Regence BlueShield Setting Facility Modifier None Typical Low $630.96 Median $645.65 Typical High $977.24 | Facility | None | $630.96 | $645.65 | $977.24 |
Regence BlueShield Setting Professional Modifier None Typical Low $467.74 Median $467.74 Typical High $707.95 | Professional | None | $467.74 | $467.74 | $707.95 |
Select Health Setting Facility Modifier None Typical Low $676.08 Median $676.08 Typical High $870.96 | Facility | None | $676.08 | $676.08 | $870.96 |
Select Health Setting Professional Modifier None Typical Low $436.52 Median $676.08 Typical High $741.31 | Professional | None | $436.52 | $676.08 | $741.31 |
United Setting Facility Modifier None Typical Low $389.05 Median $389.05 Typical High $389.05 | Facility | None | $389.05 | $389.05 | $389.05 |
United Setting Professional Modifier None Typical Low $269.15 Median $288.40 Typical High $446.68 | Professional | None | $269.15 | $288.40 | $446.68 |
9 more rates with less common billing modifiers
A modifier changes what was billed, for example a reduced or repeated service. Each of these modifiers carries under 10% of the published rates for this code. Modifier combinations, and modifiers with fewer than 30 rates for a carrier, are not listed.
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $213.80 Median $275.42 Typical High $275.42 | Professional | 52 · Reduced service | $213.80 | $275.42 | $275.42 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $85.11 Median $112.20 Typical High $112.20 | Professional | 53 · Discontinued | $85.11 | $112.20 | $112.20 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $64.57 Median $83.18 Typical High $83.18 | Professional | 55 · Aftercare only | $64.57 | $83.18 | $83.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $42.66 Median $56.23 Typical High $56.23 | Professional | 56 · Pre-op care only | $42.66 | $56.23 | $56.23 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $446.68 Median $501.19 Typical High $524.81 | Professional | 78 · Unplanned return to OR | $446.68 | $501.19 | $524.81 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $213.80 Median $275.42 Typical High $275.42 | Professional | 52 · Reduced service | $213.80 | $275.42 | $275.42 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $85.11 Median $112.20 Typical High $112.20 | Professional | 53 · Discontinued | $85.11 | $112.20 | $112.20 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $64.57 Median $83.18 Typical High $83.18 | Professional | 55 · Aftercare only | $64.57 | $83.18 | $83.18 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $42.66 Median $56.23 Typical High $56.23 | Professional | 56 · Pre-op care only | $42.66 | $56.23 | $56.23 |
Where Idaho sits
The same service costs 3.0 times more in Hawaii than in Washington, DC. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.
Idaho· 10th of 51
$575
HI $933DC $316
Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.